Provider Demographics
NPI:1710053152
Name:SCHNURER, JILL R (OD)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:R
Last Name:SCHNURER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6466 SHAPPIE RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-1960
Mailing Address - Country:US
Mailing Address - Phone:248-625-3500
Mailing Address - Fax:248-625-0025
Practice Address - Street 1:3 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1549
Practice Address - Country:US
Practice Address - Phone:248-625-3500
Practice Address - Fax:248-625-0025
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS004204152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION40420Medicare ID - Type Unspecified